Evidence map›Paper›PMID 36787953›Full record

Observational studyBMJ health & care informatics2023

Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system.

Man Qing Liang, Maxime Thibault, Philippe Jouvet, Denis Lebel, Tibor Schuster, Marie-Pierre Moreault, Aude Motulsky

Abstract readObservational Study
In one paragraph

Observational study in BMJ health & care informatics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Man Qing LiangDepartment of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada.ORCID http://orcid.org/0000-0002-7547-6164
Maxime ThibaultCHU Sainte-Justine Research Center, Montréal, Québec, Canada.
Philippe JouvetDepartment of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada.
Denis LebelCHU Sainte-Justine Research Center, Montréal, Québec, Canada.
Tibor SchusterDepartment of Family Medicine, McGill University, Montréal, Québec, Canada.
Marie-Pierre MoreaultDepartment of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada.
Aude MotulskyDepartment of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada aude.motulsky@umontreal.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesComputerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.

methodsA pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.

resultsThe global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors. DISCUSSION AND

conclusionThis study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety.

Indexed as

Medical Order Entry SystemsChildHospitals, PediatricHumansMedication ErrorsPharmaceutical PreparationsRisk ManagementPharmaceutical Preparationsclinical pharmacy information systemshealth information systemsinformation technologypharmacy researchsafety management

Identifiers

PMID36787953
PMCPMC9930550

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.